Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study.
Al OzonoffNaresh Doni JayaveluShanshan LiuEsther MelamedCarly E MillirenJingjing QiLinda N GengGrace A McComseyCharles B CairnsLindsey R BadenJoanna SchaenmanAlbert C ShawHady SamahaVicki Seyfert-MargolisFlorian KrammerLindsey B RosenHanno SteenCaitlin SyphursRavi DandekarCasey P ShannonRafick-Pierre SekalyLauren I R EhrlichDavid B CorryFarrah KheradmandMark A AtkinsonScott C BrakenridgeNelson I Agudelo HiguitaJordan P MetcalfCatherine L HoughWilliam B MesserBali PulendranKari Christine NadeauMark M DavisAna Fernandez SesmaViviana SimonHarm van BakelSeunghee Kim-SchulzeDavid A HaflerOfer LevyMonica KraftChris BimeElias K HaddadCarolyn S CalfeeDavid J ErleCharles R LangelierWalter EckalbarSteven E Bosingernull nullBjoern PetersSteven H KleinsteinElaine F ReedAlison D AugustineJoann Diray-ArceHolden Terry MaeckerMatthew C AltmanRuth Rebecca MontgomeryPatrice M BeckerNadine G RouphaelPublished in: Nature communications (2024)
Post-acute sequelae of SARS-CoV-2 (PASC) is a significant public health concern. We describe Patient Reported Outcomes (PROs) on 590 participants prospectively assessed from hospital admission for COVID-19 through one year after discharge. Modeling identified 4 PRO clusters based on reported deficits (minimal, physical, mental/cognitive, and multidomain), supporting heterogenous clinical presentations in PASC, with sub-phenotypes associated with female sex and distinctive comorbidities. During the acute phase of disease, a higher respiratory SARS-CoV-2 viral burden and lower Receptor Binding Domain and Spike antibody titers were associated with both the physical predominant and the multidomain deficit clusters. A lower frequency of circulating B lymphocytes by mass cytometry (CyTOF) was observed in the multidomain deficit cluster. Circulating fibroblast growth factor 21 (FGF21) was significantly elevated in the mental/cognitive predominant and the multidomain clusters. Future efforts to link PASC to acute anti-viral host responses may help to better target treatment and prevention of PASC.
Keyphrases
- sars cov
- liver failure
- respiratory syndrome coronavirus
- respiratory failure
- public health
- mental health
- patient reported outcomes
- drug induced
- aortic dissection
- physical activity
- coronavirus disease
- healthcare
- hepatitis b virus
- emergency department
- single cell
- extracorporeal membrane oxygenation
- risk factors
- acute respiratory distress syndrome
- transcription factor
- adverse drug
- smoking cessation
- global health